CMS Proposes Changes to Obamacare Marketplace Beginning in 2017

The Centers for Medicare & Medicaid Services (CMS) has issued its proposed annual Notice of Benefit and Payment Parameters for 2018, which proposes additional steps to strengthen the Health Insurance Marketplace. CMS said it is issuing this rule earlier in the calendar year in order to provide more certainty to the Marketplace as it continues to mature. […]

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Arizona Relaunches CHIP Health Services for Children

Today, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved Arizona’s plan to allow new enrollment in the Children’s Health Insurance Program (CHIP) after enrollment was frozen for several years. Now all states provide CHIP coverage to eligible children. “Today’s approval is a step forward for the health of Arizona children […]

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Annual Health Care Spending Reaches $10,000+ Per Person in the U.S.

Health care spending will hit $3.35 trillion this year, or $10,345 per man, woman and child in the United States, a record high, the Centers for Medicare and Medicaid Services (CMS) announced July 13. The agency  also predicted that growth in health care spending will average 5.8 percent from 2015 through 2025, outpacing growth in the […]

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HHS Issues Final Rule to Overhaul Medicaid and CHIP Managed Care

On Monday the Department of Health and Human Services (HHS) issued a final rule to overhaul managed care in the Medicaid and Children’s Health Insurance Program (CHIP) systems. The final rule has four key goals, according to HHS:  (1) supporting states’ efforts to advance delivery system reform and improvements in quality of care for Medicaid […]

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Hospital Quality Rating System Delayed by CMS

Is that hospital where you just had open-heart surgery a five star or a one star? You’ll have to wait until July, at the earliest, to find out. The Centers for Medicare and Medicaid Services (CMS) yesterday delayed implementation of its hospital quality rating system that was set to debut this week amid questions about […]

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Obamacare Sign-Ups Fall Short of Goal for 2016

On Dec. 31, 2015, about 8.8 million consumers had effectuated Health Insurance Marketplace coverage -– which means those individuals had paid their premiums and had an active policy at the end of December, the Centers for Medicare and Medicaid Services (CMS) announced. The original goal was 9.1 million paying customers. Of the approximately 8.8 million […]

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CMS Seeks to Cut Medicare Drug Payments

The Centers for Medicare & Medicaid Services (CMS) has announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing […]

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Risk Corridor Program Expects to Redistribute $7.7 Billion

The risk corridor/reinsurance program of the Affordable Care Act (ACA) is expecting collections of $7.7 billion under the program this year to compensate insurance companies that suffered losses because of high claims in 2015. The Department of Health and Human Services (HHS) will commence payments in March and wrap them up by June 30 when HHS releases […]

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CMS Announces Special Enrollment Period Confirmation Process

After big insurers like UnitedHealthcare threatened to leave the Obamacare exchanges because of abuse of the system, the Centers for Medicare and Medicaid Services (CMS) announced this past week that it was creating a Special Enrollment Period (SEP) Confirmation Process, to be phased in after public feedback. The CMS site says: Once the new Special […]

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UnitedHealth, Humana Bleed Red for Obamacare

UnitedHealth Group Inc., the nation’s largest health insurer which last year said it might withdraw from the Obamacare insurance exchanges, this week increased projected 2016 Affordable Care Act (ACA) losses from $400 million to $500 million. Humana Inc. also disclosed that it was setting up a “premium deficiency reserve” for its anticipated 2016 ACA losses. […]

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